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Non-Hodgkin Lymphoma — St Jude (Murphy) Stage

Paediatric NHL staging (Toronto Tier 1).

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1 What is the Non-Hodgkin Lymphoma — St Jude (Murphy) Stage?

The Non-Hodgkin Lymphoma — St Jude (Murphy) Stage is a oncology scoring tool used in paediatric practice. Paediatric NHL staging (Toronto Tier 1). It scores 1 criteria and interprets the total across 4 bands, so the number always arrives with the severity it implies rather than on its own. In PediAid each criterion is shown as a labelled option with the weight it carries, so the total can be checked rather than taken on trust.

2 When to use it

  • Grading severity at the bedside in oncology
  • Recording an objective severity band in the case notes
  • Deciding when a total crosses the threshold for escalation
  • Re-scoring to track whether a child is improving or deteriorating
  • Checking the exact criteria of a score used infrequently

3 Formula & method

The score sums 1 criteria: Extent of disease. Totals are then banded: 1 stage or more - Stage I: stage I - limited disease; excellent prognosis with short-course therapy; 2 stage or more - Stage II: stage II - limited disease, generally treated on low-risk protocols; 3 stage or more - Stage III: stage III - advanced disease requiring intensified multi-agent chemotherapy; 4 stage or more - Stage IV: stage IV - CNS and/or marrow involvement. Highest-intensity therapy with CNS-directed treatment; marrow blasts ≥25 % is classified as leukaemia instead.
  • Source (staging): Murphy SB. Classification, staging and end results of treatment of childhood non-Hodgkin lymphomas. Semin Oncol 1980;7:332-9.
  • Source: Gupta S, Aitken JF, Bartels U et al. Paediatric cancer stage in population-based cancer registries: the Toronto consensus principles and guidelines. Lancet Oncol 2016;17:e163-72.

4 Frequently asked questions

How many criteria does the Non-Hodgkin Lymphoma — St Jude (Murphy) Stage use?

1. They are Extent of disease.

What do the bands of the Non-Hodgkin Lymphoma — St Jude (Murphy) Stage mean?

The total is interpreted as: 1 stage or more - Stage I: stage I - limited disease; excellent prognosis with short-course therapy; 2 stage or more - Stage II: stage II - limited disease, generally treated on low-risk protocols; 3 stage or more - Stage III: stage III - advanced disease requiring intensified multi-agent chemotherapy; 4 stage or more - Stage IV: stage IV - CNS and/or marrow involvement. Highest-intensity therapy with CNS-directed treatment; marrow blasts ≥25 % is classified as leukaemia instead.

Does the score replace clinical judgement?

No. It is a structured way to record and communicate severity. A clinician concerned about a child should act on that concern regardless of the total.

Where does this score come from?

Source (staging): Murphy SB. Classification, staging and end results of treatment of childhood non-Hodgkin lymphomas. Semin Oncol 1980;7:332-9.

Does it work offline?

Yes. Score definitions are bundled with the PediAid app, so the score computes without a connection.

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For qualified clinicians. This page and the PediAid app are a clinical aid only. Calculations and reference data must be verified against the patient's clinical context, the source guideline and your local protocols before any treatment decision is made.